EMR

The Procedure

An Endoscopic Mucosal Resection (EMR) is a minimally invasive procedure to remove large or flat growths, such as polyps or early-stage cancers, from the lining of the bowel using an endoscope. The endoscope is a flexible, lighted tube with a camera and instruments that is passed though the anus into the colon (large bowel) and through to the lower part of the small bowel. The polyp is then removed with a submucosal injection in which a fluid is injected under the lesion to create a cushion, separating it from the deeper muscle layer of the bowel wall. An electrified snare is then used to remove the raised lesion. The electrical current from the snare seals the wound and stops the bleeding.

• During the test, you will be lying on your left side. A specialist anaesthetist will administer short-acting sedative drugs by vein and then the examination will begin.

• During the test you may feel some discomfort as the bowel is inflated with air; this is mostly removed at the end.

• The duration of the procedure varies but will be longer than standard colonoscopy. The medication does not change

POST PROCEDURE

After the test you will be sleepy for at least one hour. Once you awaken you will be given some light refreshment. If you feel well you will be able to go home within one to two hours. The hospital anaesthetic departments policy states you must be escorted home (you cannot travel unaccompanied in a taxi), and you must have someone stay with you overnight. The sedative drugs impair judgement, so you must not drive a car until the next day.

POTENTIAL COMPLICATIONS

There are potential hazards to this procedure including the potential for death. The overall risk is very small. It includes such things as vomiting, pain and perforation (bursting) of the colon. Perforation occurs very rarely (about 1 in 1000) cases. If it occurs you may require surgery within 24-48 hours and would likely recover in hospital over 7-10 days. The other potential complication is post polypectomy bleeding. This can occur immediately after the procedure but can occur up to 7-10 days following the procedure. Risk of bleeding is increased in patients on blood thinning medications. Please advise your doctor if you take any blood thinners. If at any time you have any questions regarding the EMR, please ask. We shall answer as completely as possible. Please inform us if you have any pain, fever or vomiting in the 24 to 48 hours following the procedure.